Heart failure & cardiomyopathies
Acute heart failure with systolic dysfunction in paediatric patients: aetiology, risk factors, and in-hospital prognosis
Authors' conclusion
Acute heart failure with systolic dysfunction in children has an unfavourable prognosis, however most patients improved during hospitalization. In our study, cardiomyopathy aetiology predicted worse outcomes. In turn, infective aetiology, younger age, higher EF, and SpO2 were independent factors of better prognosis.
Study context
- Population
- Paediatric patients hospitalized for new-onset acute heart failure (AHF) with systolic dysfunction or the first exacerbation with reported systolic dysfunction of chronic heart failure (CHF)
- Participants
- 162 consecutive paediatric patients
- Exposure
- Patients with >5% ejection fraction (EF) improvement before discharge vs those with EF deterioration, ≤5% EF improvement, or death during hospitalization
- >5% improvement in EFn = 115
- EF deterioration, ≤5% EF improvement, or deathn = 47
- Outcome
- Mortality
- Follow-up
- During hospitalization
Methodological detailsconsecutive
- Consecutive
Main finding
As reported in the abstract
Mortality rate
12.3%
Observational data: associations, not effects.
Further findings
Independent factors of worse outcomes
| OR (CI) | ||
|---|---|---|
| Cardiomyopathies aetiologyWorse outcomes | 2.762 (1.210–6.307) | |
| Older ageWorse outcomes | 1.006 (1.000–1.011) | |
| 0.10.31310Odds ratio (log scale) |
Factors of better prognosis
| OR (CI) | ||
|---|---|---|
| Infective aetiologyBetter prognosis | 0.083 (0.010–0.664) | |
| Higher EFBetter prognosis | 0.953 (0.905–0.999) | |
| Oxygen saturation (SpO2)Better prognosis | 0.951 (0.905–0.992) | |
| 0.050.21520Odds ratio (log scale) |
Outcomes, de novo AHF vs CHF exacerbation
- De novo AHF had better outcomes than CHF exacerbation
- P = 0.014
Baseline characteristics
- Males
- 58%
- Females
- 42%
- Median age
- 1 [interquartile range (IQR) 0-8] year, 14 (IQR 2-101) months
AHF aetiologies
- Congenital heart defects
- 51.2%
- Cardiomyopathy
- 20.4%
- Infections
- 14.2%
- Arrhythmias
- 11.7%
- Others
- 2.5%
Original publication
Acute heart failure with systolic dysfunction in paediatric patients: aetiology, risk factors, and in-hospital prognosis. Eur Heart J Acute Cardiovasc Care. Published 2 April 2025. doi:10.
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